scholarly journals Factors Associated with Poststroke Anxiety: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Francesca Wright ◽  
Simiao Wu ◽  
Ho-Yan Yvonne Chun ◽  
Gillian Mead

Background and Purpose.Anxiety affects 25% of stroke survivors. There are no effective treatments. Poststroke depression, prestroke anxiety and depression, locus of control, coping, confidence, fatigue, and sleep are factors that may be associated with poststroke anxiety and can potentially be targeted by therapy. We systematically reviewed the literature and performed a meta-analysis to identify associations with these factors.Methods. We searched electronic databases from January 2014 to July 2015 to complement a literature search performed from inception to May 2014. Study quality was assessed using an internationally endorsed checklist. We used odds ratios (ORs) to estimate the strength of associations and random-effects modelling to calculate summary effect sizes.Results.There were 24 studies recruiting 15448 patients. Quality of reporting was satisfactory. 13 studies with 2408 patients reported associations between poststroke anxiety and poststroke depression (OR=4.66, 95% confidence interval: 2.23, 9.74). One study reported association with prestroke anxiety, three with prestroke depression, one with fatigue, and two with sleep. No studies reported on locus of control, coping, or confidence.Conclusion.Poststroke anxiety was associated with depression but there are limited data on other modifiable associations. Further research is needed to identify potential targets for treatment.

2000 ◽  
Vol 88 (5) ◽  
pp. 1730-1736 ◽  
Author(s):  
George A. Kelley ◽  
Kristi S. Kelley ◽  
Zung Vu Tran

The purpose of this study was to use the meta-analytic approach to examine the effects of exercise on bone mineral density (BMD) in men. A total of 26 effect sizes (ES) representing 225 subjects from 8 studies met the criteria for inclusion. When BMD sites assessed were specific to the sites loaded during exercise, increases of ∼2.6% (2.1% in the exercisers and −0.5% in the controls) were found. These results were statistically significant (ES = 0.213, 95% bootstrap confidence interval = 0.007–0.452). Statistically significant ES changes were found for older (>31 yr) but not younger (<31 yr) adults, with differences between groups statistically significant ( P = 0.04). Statistically significant changes were also observed at the femur, lumbar, and os calcis sites. The results of this study suggest that site-specific exercise may help improve and maintain BMD at the femur, lumbar, and os calcis sites in older men. However, the biological importance of the small changes observed for most outcomes, quality of studies, and limited data pool prevent us from forming any firm conclusion regarding the use of exercise for maintaining and/or improving BMD in men. Clearly, a need exists for additional studies.


2015 ◽  
Vol 206 (1) ◽  
pp. 7-16 ◽  
Author(s):  
Ioana A. Cristea ◽  
Robin N. Kok ◽  
Pim Cuijpers

BackgroundCognitive bias modification (CBM) interventions are strongly advocated in research and clinical practice.AimsTo examine the efficiency of CBM for clinically relevant outcomes, along with study quality, publication bias and potential moderators.MethodWe included randomised controlled trials (RCTs) of CBM interventions that reported clinically relevant outcomes assessed with standardised instruments.ResultsWe identified 49 trials and grouped outcomes into anxiety and depression. Effect sizes were small considering all the samples, and mostly non-significant for patient samples. Effect sizes became non-significant when outliers were excluded and after adjustment for publication bias. The quality of the RCTs was suboptimal.ConclusionsCBM may have small effects on mental health problems, but it is also very well possible that there are no significant clinically relevant effects. Research in this field is hampered by small and low-quality trials, and by risk of publication bias. Many positive outcomes are driven by extreme outliers.


2020 ◽  
Author(s):  
Arfan Ahmed ◽  
Nashva ALi ◽  
Sarah Aziz ◽  
Alaa A Abd-Alrazaq ◽  
Asmaa Hassan ◽  
...  

BACKGROUND Anxiety and depression rates are at an all-time high along with other mental health disorders. Smartphone-based mental health chatbots or conversational agents can aid psychiatrists and replace some of the costly human based interaction and represent a unique opportunity to expand the availability and quality of mental health services and treatment. Regular up-to-date reviews will allow medics and individuals to recommend or use anxiety and depression related smartphone based chatbots with greater confidence. OBJECTIVE Assess the quality and characteristics of chatbots for anxiety and depression available on Android and iOS systems. METHODS A search was performed in the App Store and Google Play Store following the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) protocol to identify existing chatbots for anxiety and depression. Eligibility of the chatbots was assessed by two individuals based on predefined eligibility criteria. Meta-data of the included chatbots and their characteristics were extracted from their description and upon installation by 2 reviewers. Finally, chatbots quality information was assessed by following the mHONcode principles. RESULTS Although around 1000 anxiety and depression related chatbots exist, only a few (n=11) contained actual chatbots that could provide the user a real substitute for a human-human based interaction, even with today's Artificial Intelligence advancements, only one of these chatbots had voice as an input/output modality. Of the selected apps that contained chatbots all were clearly built with a therapeutic human substitute goal in mind. The majority had high user ratings and downloads highlighting the popularity of such chatbots and their promising future within the realm of anxiety and depression. CONCLUSIONS Anxiety and depression chatbot apps have the potential to increase the capacity of mental health self-care providing much needed assistance to professionals. In the current covid-19 pandemic, chatbots can also serve as a conversational companion with the potential of combating loneliness, especially in lockdowns where there is a lack of social interaction. Due to the ubiquitous nature of chatbots users can access them on-demand at the touch of a screen on ones’ smartphone. Self-care interventions are known to be effective and exist in various forms and some can be made available as chatbot features, such as assessment, mood tracking, medicine tracking, or simply providing conversation in times of loneliness.


2018 ◽  
Vol 22 (2) ◽  
pp. 64-69
Author(s):  
Su-Ro Kim ◽  
Sung-Wan Kim ◽  
Tae-Young Jung ◽  
Jae-Min Kim ◽  
Il-Seon Shin ◽  
...  

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Liansheng Larry Tang ◽  
Michael Caudy ◽  
Faye Taxman

Multiple meta-analyses may use similar search criteria and focus on the same topic of interest, but they may yield different or sometimes discordant results. The lack of statistical methods for synthesizing these findings makes it challenging to properly interpret the results from multiple meta-analyses, especially when their results are conflicting. In this paper, we first introduce a method to synthesize the meta-analytic results when multiple meta-analyses use the same type of summary effect estimates. When meta-analyses use different types of effect sizes, the meta-analysis results cannot be directly combined. We propose a two-step frequentist procedure to first convert the effect size estimates to the same metric and then summarize them with a weighted mean estimate. Our proposed method offers several advantages over existing methods by Hemming et al. (2012). First, different types of summary effect sizes are considered. Second, our method provides the same overall effect size as conducting a meta-analysis on all individual studies from multiple meta-analyses. We illustrate the application of the proposed methods in two examples and discuss their implications for the field of meta-analysis.


2021 ◽  
Vol 12 ◽  
Author(s):  
Xiaocui Qin ◽  
Xia Zhang ◽  
Pinyu Li ◽  
Min Wang ◽  
Li Yan ◽  
...  

Background: Diabetes mellitus (DM) increases the risk of Parkinson's disease (PD). However, whether DM medications play a part on that increased PD risk is unclear. We designed this meta-analysis to assess the influence of different oral DM medications on the PD risk in patients with DM.Methods: We searched PubMed, Embase, and CENTRAL databases for relevant studies up until January 2021. We pooled adjusted outcomes to assess the PD risk in patients using different DM medications including sulfonylurea, metformin, glitazones (GTZ), dipeptidyl peptidase-4 inhibitors (DPP4i), and glucagon-like peptide-1 agonists (GLP1a).Results: We included 10 studies in our analysis. Our results indicate a lack of significant association between the PD risk and the use of sulfonylureas (three studies; HR, 1.26; 95% CI, 0.95 to 1.66; I2, 70%; p = 0.11), DPP4i (three studies; HR, 0.69; 95% CI, 0.35 to 1.38; I2, 88%; p = 0.30), metformin (five studies; HR, 1.23; 95% CI, 0.98 to 1.78; I2, 84%; p = 0.13), and GTZ (six studies; HR, 0.88; 95% CI, 0.66 to 1.16; I2, 92%; p = 0.35). After exclusion of a single study in the GTZ analysis, our results indicate a significantly reduced PD risk with GTZ use (HR, 0.78; 95% CI, 0.65 to 0.93; I2, 59%; p = 0.06). Similarly, after the exclusion of a single study, our results indicate a significantly increased PD risk with the use of metformin (HR, 1.50; 95% CI, 1.11 to 2.02; I2, 80%; p = 0.008). We also found a significantly reduced PD risk with the use of GLP1a (two studies; HR, 0.41; 95% CI, 0.19 to 0.87; I2, 0%; p = 0.02).Conclusion: The role of different DM medications on the PD risk remains unclear, and the quality of studies is low. While our analysis suggests a lack of association between the use of metformin, GTZ, DPP4i, and sulfonylureas and the PD risk, metformin (to a higher degree) and GTZ may still increase the risk. Limited data suggest a protective effect of GLP1a on the PD risk.


2021 ◽  
Vol 12 ◽  
Author(s):  
Eszter Varga ◽  
András Hajnal ◽  
Alexandra Soós ◽  
Péter Hegyi ◽  
Dóra Kovács ◽  
...  

Introduction: Minor physical anomalies (MPAs) may reflect basic neurobiological features underlying bipolar disorders (BPD), as they are sensitive physical indicators of morphogenetic failure of the brain. Despite several researches about the presence of MPAs in BPD, the results are still controversial.Objectives: The aim of the present meta-analysis was to assess the standardized weighted mean effect sizes of MPAs in BPD and to examine if MPAs may be found predominantly in the head and/or facial regions in BPD patients compared to controls (HC).Methods: Four studies, involving 155 patients with BPD, and 187 HC, were involved in the analysis after searching the literature. For the investigation of MPAs in the peripheral (MPA-P) and in the head and facial regions (MPA-CF), two studies involving 121 BPD patients, and 133 HC passed the inclusion criteria.Results: The number of the MPAs in the BPD group was significantly higher compared to HC. Another important finding of the present study is that BPD patients' MPA-P scores do not significantly differ from those of the HC. In contrast, BPD patients' MPA-CF scores were found to be significantly higher compared to HC subjects. It is important to note that there was a low number of eligible publications included, which caused higher heterogeneity.Conclusions: Low quality of evidence suggests that MPAs are more common in patients with BPD than in HC and the higher rate of MPAs is found predominantly in the head and facial regions.


2019 ◽  
Vol 20 (2) ◽  
pp. 199-216 ◽  
Author(s):  
C. B. Winder ◽  
J. M. Sargeant ◽  
D. Hu ◽  
C. Wang ◽  
D. F. Kelton ◽  
...  

AbstractA systematic review and network meta-analysis were conducted to assess the relative efficacy of antimicrobial therapy given to dairy cows at dry-off. Eligible studies were controlled trials assessing the use of antimicrobials compared to no treatment or an alternative treatment, and assessed one or more of the following outcomes: incidence of intramammary infection (IMI) at calving, incidence of IMI during the first 30 days in milk (DIM), or incidence of clinical mastitis during the first 30 DIM. Databases and conference proceedings were searched for relevant articles. The potential for bias was assessed using the Cochrane Risk of Bias 2.0 algorithm. From 3480 initially identified records, 45 trials had data extracted for one or more outcomes. Network meta-analysis was conducted for IMI at calving. The use of cephalosporins, cloxacillin, or penicillin with aminoglycoside significantly reduced the risk of new IMI at calving compared to non-treated controls (cephalosporins, RR = 0.37, 95% CI 0.23–0.65; cloxacillin, RR = 0.55, 95% CI 0.38–0.79; penicillin with aminoglycoside, RR = 0.42, 95% CI 0.26–0.72). Synthesis revealed challenges with a comparability of outcomes, replication of interventions, definitions of outcomes, and quality of reporting. The use of reporting guidelines, replication among interventions, and standardization of outcome definitions would increase the utility of primary research in this area.


2019 ◽  
Vol 20 (2) ◽  
pp. 182-198 ◽  
Author(s):  
C. B. Winder ◽  
J. M. Sargeant ◽  
D. Hu ◽  
C. Wang ◽  
D. F. Kelton ◽  
...  

AbstractA systematic review and network meta-analysis were conducted to assess the relative efficacy of internal or external teat sealants given at dry-off in dairy cattle. Controlled trials were eligible if they assessed the use of internal or external teat sealants, with or without concurrent antimicrobial therapy, compared to no treatment or an alternative treatment, and measured one or more of the following outcomes: incidence of intramammary infection (IMI) at calving, IMI during the first 30 days in milk (DIM), or clinical mastitis during the first 30 DIM. Risk of bias was based on the Cochrane Risk of Bias 2.0 tool with modified signaling questions. From 2280 initially identified records, 32 trials had data extracted for one or more outcomes. Network meta-analysis was conducted for IMI at calving. Use of an internal teat sealant (bismuth subnitrate) significantly reduced the risk of new IMI at calving compared to non-treated controls (RR = 0.36, 95% CI 0.25–0.72). For comparisons between antimicrobial and teat sealant groups, concerns regarding precision were seen. Synthesis of the primary research identified important challenges related to the comparability of outcomes, replication and connection of interventions, and quality of reporting of study conduct.


Sign in / Sign up

Export Citation Format

Share Document